A refrigerator is a cooling apparatus. Health facility refrigerators may be powered by electricity, kerosene, paraffin, bottled gas or solar energy. Electric refrigerators are usually the least costly to run and the easiest to maintain, but they must have a reliable electricity supply, which is not often possible in rural Health Posts in Ethiopia. Different refrigerators have different capacities for storing vaccines and for freezing and storing ice-packs (Figure 6.2).

Figure 6.2 A Health Extension Worker with a kerosene-powered refrigerator in a rural Health Post in SNNPR, Ethiopia. This refrigerator has a freezer compartment on top, and plenty of space for the vaccines, diluents and other supplies that must be kept cold. (Photos: Janet Haresnape)

A refrigerator in a Health Post should be able to hold:

One month’s supply of vaccines and diluents in the refrigerator compartment.
A minimum stock of one to two weeks’ supply of vaccines and diluents (i.e. an additional 25% of the standard stock).
Frozen ice-packs (strong, specially made plastic bottles containing frozen water) standing in the freezer compartment for at least 24 hours to become fully frozen.

Do not put frozen ice-packs into the main refrigerator compartment! They could cause the temperature to drop too low and destroy the freeze-sensitive vaccines.

Unfrozen chilled ice-packs in the refrigerator compartment (Figure 6.3); they help to keep the refrigerator cold for a while if there is a power failure. You can also keep ordinary plastic bottles filled with chilled water in the refrigerator for the same purpose.

Figure 6.3 These unfrozen (chilled water) ice-packs help to keep the refrigerator cold during a power failure. They should always be stored vertically to avoid possible leaks. (Photo: Basiro Davey)